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Cited by 111Adrenal Hormones and DisordersPituitary Gland Disorders and TreatmentsClinical Laboratory Practices and Quality Control

Salivary cortisol and cortisone by LC–MS/MS: validation, reference intervals and diagnostic accuracy in Cushing's syndrome

Antonelli, Giorgia, Ceccato, Filippo, Artusi, Carlo, Marinova, Mariela, Plebani, Mario·2015·Clinica Chimica Acta
DOI 10.1016/j.cca.2015.10.004
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Abstract

Background The Endocrine Society recommends late-night salivary cortisol (LNS-F) as a first-line screening test for Cushing's syndrome (CS). In the parotid gland, 11β-hydroxysteroid dehydrogenase type 2 inactivates cortisol (F) to cortisone (E), a known source of interference in the more frequently used immunoassays. A highly specific method is mandatory in determining salivary F and E: it is widely accepted that liquid chromatography-tandem mass spectrometry (LC-MS/MS) is the best available technique for this purpose.Methods A LC-MS/MS method with SPE of saliva samples was developed and validated. Appropriate awakening and bedtime reference ranges were established. The diagnostic performance for F, E and the ratio at bedtime was evaluated in 25 cases of CS.Results The method was linear, with up to 55.4 nmol/L and 51.0 nmol/L, LLOQ of 0.51 nmol/L and 0.55 nmol/L, for F and E, respectively. Within-run and between-run imprecisions were <10% for both analytes. No ion suppression was observed. A cut-off of 2.4 nmol/L for LNS-F yielded a sensitivity of 100% and a specificity of 98% in the diagnosis of CS.Conclusions The analytical performance of this method justifies its introduction into clinical practice, thus allowing clinicians the opportunity to further investigate CS and other endocrine diseases.

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Authors
Antonelli, G., Ceccato, F., Artusi, C., Marinova, M., & Plebani, M.
Affiliations
University of Padua (IT)
Corresponding author
Antonelli, Giorgia
ORCID
Venue
Clinica Chimica Acta
Publisher
Elsevier BV
Published
2015-12
Volume
451
Issue
Pt B
Pages
247-251
ISSN
0009-8981 (ISSN-L)
DOI
10.1016/j.cca.2015.10.004
OpenAlex
W1839948300
Cited by
111
References
36
Citations by year
2026: 6 · 2025: 10 · 2024: 8 · 2023: 8 · 2022: 8 · 2021: 11 · 2020: 13 · 2019: 13 · 2018: 12 · 2017: 14 · 2016: 7 · 2015: 1
FWCI
9.83
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Clinica Chimica Acta (publishedVersion)
  • PubMed (publishedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
Keywords
Cushing's syndrome, salivary cortisol, salivary cortisone, late-night salivary cortisol, LC-MS/MS method validation, 11β-hydroxysteroid dehydrogenase type 2, diagnostic accuracy, reference values, screening test
MeSH terms
Adult, Aged, Aged, 80 and over, Chromatography, High Pressure Liquid, Cortisone, Cushing Syndrome, Female, Humans, Hydrocortisone, Male, Middle Aged, Reference Values, Saliva, Tandem Mass Spectrometry, Young Adult

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